Mobile Health Intervention Stepathlon Improved Physical Activity and Weight

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Mobile health initiative, Stepathlon, improved physical activity and weight as well as sitting duration.

Large-scale, low-cost mobile-health (mHealth) intervention was tied to improved physical activity, weight, and sitting duration.

Anand Ganesan, MBBS, PhD of the Department of Cardiovascular Medicine at Flinders Medical Centre in Adelaide, Australia presented the study findings at the 2016 Annual American College of Cardiology Scientific Sessions & Expo.

“This data set represents the largest published data set in the mobile health and exceeds the size of previous meta-analyses by a substantial figure,” Dr Ganesan stated at an ACC press conference.

“There were reproducible, statistically significant improvement in physical activity and weight in distributed geographically and sociocultural settings. It demonstrates the capacity of endogenous innovation in lower-middle income countries to develop low-cost, internationally applicable mHealth programs,” Dr Ganesan continued.

The growing access to mobile Internet opens the door to implementation of mHealth technology to combat the negative consequences of sedentary behavior, according to the paper simultaneously published in the Journal of the American College of Cardiology. Despite small studies in targeted groups demonstrating improvements in physical activity, there is limited data in a practical, large-scale setting.   

Dr Ganesan and colleagues analyzed prospective data from the Stepathlon cohort consisting of participants of a 100 day global event during 3 consecutive years (2012, 2013, and 2014). The work-based intervention included teams competing to increase daily activity and pedometer monitored steps through an interactive, mobile application.

During the 3 year program, participants from 64 countries and 481 employers completed pre- and post- questionnaires (69219 pre-event questionnaires and 36 652 post-event questionnaires; 53% response rate).

Steps increased by 3519 steps per day overall (95% confidence interval [CI]: 3484 to 3553; P<.0001) with similar increases in men (+3398, 95% CI: 3356 to 3440; P<.0001), women (+3159, 95% CI: 3086 to 3232; P<.0001), and in each year (P<.0001 for all).

Further, they demonstrated an increase in 0.89 days of exercise weekly after the intervention (95% CI: +0.87 to +0.92 days; P<.0001) and a higher odds of exercising ≥30 minutes daily (odds ratio [OR]: 1.65; 95% CI: 1.61-1.68; P<.0001).

Sitting hours (-0.74 hours; 95% CI: -0.78 to -0.71, P<.001) and weight (-1.45 kg, 95% CI: -1.53 to -1.38, P<.0001) was also reduced in the in Stepathlon participants. Similar reductions in sitting hours and weight were demonstrated across income levels, geographic regions, years of study, and in men and women.

Finally, a decrease in sitting and an increase in steps and exercise days were predictors of weight loss (P<.0001 for all).

“These data demonstrate that utilization of mHealth-based approaches may facilitate low-cost and large-scale global implementation of a workplace physical activity intervention, leading to modest but reproducible short-term population-level improvements in step counts, exercise duration, sitting and weight,” the study authors concluded.

Disclosures: Dr Hendriks was supported by the National Heart Foundation of Australia and Dr Anand Ganesan was supported by the National Health and Medical Research Council of Australia. Drs Selvanayagam, McGavigan, and Chew report disclosures related to biotechnology and pharmaceutical companies. Mr Bilsborough is employed by Stepathlon Private Limited.


  1. Ganesan AN, Louise J, Horsfall M. Presentation 404-14: International Mobile-Health Intervention on Physical Activity, Sitting, and Weight: The Stepathlon Cardiovascular Health Study. Presented at the 65th Annual Scientific Session and Expo of the American College of Cardiology. April 2-4, 2016; Chicago, IL. 
  2. Ganesan AN, Louise J, Horsfall M, et al. International mobile-health intervention on physical activity, sitting, and weight: the Stepathlon Cardiovascular Health Study. J Am Coll Cardio. 2016. doi: 10.1016/j.jacc.2016.03.472.